Pharmaceutical Side Effects and the Sex Differences in Depression and Distress

Abstract

Introduction: Women suffer from depression at higher rates than men. This difference is well established, although a consolidated explanation remains elusive. This study examines the role played by medications with depression or suicidality as a potential side effect in explaining the sex difference in depression.

Methods: Data were analyzed for 224,810 U.S. adults aged ≥18 years from the 2008-2018 Medical Expenditure Panel Survey. Linear and logistic regressions were used to assess the sex differences in distress and depression while controlling for sociodemographic characteristics, healthcare access, health conditions, and the use of medications with depression or suicidality as a side effect.

Results: 41% and 28% of women used ≥1 medication with depression and suicidality as a side effect compared with 27% and 17% of men, respectively. When controlling for sociodemographic characteristics, healthcare access, and health conditions, women were more likely to report significant distress (OR=1.16, 95% CI=1.10, 1.24) and major depression (OR=1.12, 95% CI=1.07, 1.18) than men. In models that further adjusted for the use of medications with depression or suicidality as a side effect, the sex differences became statistically nonsignificant for both distress (OR=0.97, 95% CI=0.91, 1.03) and depression (OR=0.97, 95% CI=0.92, 1.02). Nonhormone medications (rather than hormone medications) with such side effects helped explain the sex differences in distress and depression.

Conclusions: Findings suggest a significant sex difference in pharmaceutical treatment and the potential consequences of pharmaceutical side effects on distress and depression. These results highlight the importance of pharmaceutical side effects in understanding health and health disparities.